Provider Demographics
NPI:1073577631
Name:PARISH, ANJALI PRASAD (MD)
Entity Type:Individual
Prefix:DR
First Name:ANJALI
Middle Name:PRASAD
Last Name:PARISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANJALI
Other - Middle Name:
Other - Last Name:PRASAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1499 WALTON WAY
Mailing Address - Street 2:STE 1400
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901
Mailing Address - Country:US
Mailing Address - Phone:706-724-6100
Mailing Address - Fax:706-724-1600
Practice Address - Street 1:1120 15TH ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912
Practice Address - Country:US
Practice Address - Phone:706-721-2331
Practice Address - Fax:706-721-7531
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0490822080N0001X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine